Workplace drug testing:
Evidence and issues
Ken Pidd
National Centre for Education & Training on Addiction
(NCETA)
1. Alcohol, drugs & the workplace:
putting it into a safety context
2. Workplace drug testing as a
response to safety risk
Workforce & workplace use
• Workforce use
• Overall use
• Impact on workplace safety indirect & dependent on other
factors (fatigue, hangover, health outcomes, addiction)
• Workplace use
• Use at work/work under the influence
• Impact on workplace safety directly associated with use
(intoxication/impairment)
1. Alcohol, drugs & the workplace:
putting it into a safety context
Workforce alcohol use by industry
% drinking weekly (or more often) at risk levels
40%
35.6%
35%
34.7%
30%
28%
26%
24%
25%
19.3%
20%
15%
10%
5%
0%
Construction
Mining
Utilities
Transport
Agriculture
All
Workforce drug use by industry
% of workers using drugs (last 12 months)
30%
25%
20%
27.3%
25%
21.5%
20.9%
18%
15.4%
15%
10%
5%
0%
Construction workforce use in context
80%
72.7%
70%
64.4%
60%
50%
40%
35.6%
27.3%
30%
20%
YES
NO
YES
NO
10%
0%
Risky alcohol use
Drug use
Construction workforce use in context
Risky alcohol use
Drug use
Workplace use
20%
18%
16%
14%
12%
10%
8%
6%
4%
2%
0%
18.6%
14.7%
12.0%
11.0%
9.2%
7.8%
7.5%
under influence
6.0%
Hospitality
Finance
use at work
8.7%
Utilities
Construction
Alcohol use at work
5.6%
All
Workplace use
10%
9%
8%
7%
5.9%
6%
4.8%
5%
use at work
under influence
4%
3%
2%
2.5%
1.9%
1.5%
1.4%
1.4%
0.8%
1%
0.9%
0.2%
0%
Transport
Hospitality
Construction
Finance
Drug use at work
All
Construction workplace use in context
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
95.2%
94%
Yes
No
6%
Alcohol
4.8%
Drugs
Work under the influence
Construction workplace use in context
Work under the influence
Alcohol & drug related accidents
• Up to 15% of all workplace injuries/accidents
may be related to alcohol or drug use
• At least 85% of injuries are not
• Other factors associated with workplace injuries
•
•
•
•
Unsafe work conditions
Fatigue
Unsafe equipment
Poor/no training
2.
Workplace drug testing as a
response to safety risk
Types of workplace tests
• Breath analysis (use increasing)
• Urinalysis (most common)
• Saliva (growing popularity & potential)
Breath Testing
Advantages
•Onsite test that can reliably indicate
alcohol intoxication/impairment
•Non-intrusive
•Wide acceptance
Disadvantages
•Can only detect alcohol use
•Requires constant calibration (can be affected by paint & solvents)
•Cannot detect “hangover” effects
Urinalysis
Advantages
•In-expensive (test)
•Fully developed methodology
•Fewer sample storage issues
Disadvantages
•Collection can be expensive & time consuming
•Cannot detect impairment/intoxication
•Cannot detect hangover effects
•Long window of detection (cannabis)ay miss
Saliva testing
Advantages
•Relatively non-intrusive
•Can detect recent use
•Difficult to adulterate sample
Disadvantages
•Can be difficult to collect sufficient fluid
•Low reliability (cannabis)
•Cannot detect intoxication/impairment
•Cannot detect “hangover” effects
•Sample can deteriorate at room temp
Methods of testing
• On-site screen (initial test)
• Laboratory analysis
(confirmation of positives)
On-site drug screening
• Advantages:
– Relatively inexpensive (compared to lab testing)
– Quick cost effective initial screen
– Easy to administer
• Disadvantages
– Cannot distinguish between prescribed drug use & illicit drug use
– On-site tests have a much lower level of accuracy & reliability
than lab testing
– Subject to user error
Laboratory drug analysis
• Advantages:
– Much more reliable & accurate than on-site tests
– Can detect a much wider range of drugs
– Can detect both the level of drug/drug metabolite
present
• but test itself cannot determine intoxication/impairment,
amount use or pattern of use
Laboratory drug analysis
• Disadvantages:
– Can be expensive & time consuming
– Cannot distinguish between legitimate prescription drug use and
illegitimate use without donor’s medical background
– As with on-site tests, some prescribed drugs/food stuffs can
produce false positives
– As with on-site tests, subject to human error
Testing programs
Pre-employment
Post accident/incident
Random
For cause
Pre-employment
• Advantages
– Cost effective method of screening out drug users
• Disadvantages
– Can deter skilled & capable workers from applying
– Can screen in some drug users & screen out
some non-drug users
– Limited efficacy
– Rationale based on false assumptions
Post accident/incident
• Advantages
(accident/near miss)
– Allows collection of statistics on potential drug-related
incidents
• Disadvantages
–
–
–
–
Limited evidence of causal role
May lead to under reporting of minor accidents & near misses
May lead to delay in treatment seeking
Potential to jeopardise ‘no fault’ workers compensation
schemes
Random
• Advantages
– Possibly most effective method of deterring use
• Disadvantages
– Receives least support from employees
– Most open to employer abuse
– Fosters culture of mistrust
For cause
• Advantages
– Only applied to individuals ‘suspected’ of drug
use/impairment
• Disadvantages
– Can be used to victimise employee
– Subjective application
The efficacy of testing
•Deterrence effect?
•Reduces prevalence of injuries/accidents?
•Improves safety?
•Cost effective?
Main problems with workplace testing
•A test can only determine past drug use
• It cannot determine:
– the degree of impairment/intoxication
• except alcohol breath analysis
–
–
–
–
the amount used or the time of use
how it was administered
If the person is a chronic/casual user or an addict
If the drug was prescribed
• Testing may mask the true extent of risk
• Underreporting of accidents & near misses
• Avoidance
• Change in pattern of use, masking agents, sample
substitution
• Testing may contribute to the risk
• Displacement to more dangerous - but less
detectable - drug use (ice/speed, synthetics)
Australian standards
• AS 4760 – 2006
– Procedures for specimen collection & the detection
& quantitation of drugs in oral fluid
• AS/NZS 4308 – 2001
– Procedures for the collection, detection &
quantitation of drugs of abuse in urine
• Problems:
• Voluntary
• Mainly apply to laboratory, not on-site testing
Other issues
• Lack of industry regulation
• Lack of relevant legislation
• Limited understanding of testing
• May divert resources away from more
effective strategies
• Focus on individual worker
• Employer control/intrusion
Thank you
Consultancy & Advice on:
Workplace AOD policies
Workplace AOD intervention strategies
Tailored employee awareness & education sessions
Tailored supervisor & OHS staff training programs
Evaluation of education, training & intervention
strategies
www.nceta.flinders.edu.au